Table 2.
Pathologist treatment suggestions compared to NCCN**** guidelines for melanoma in situ or invasive melanoma by pathologist characteristics
| Pathologist characteristics | Melanoma in situ | Invasive melanoma | |||
|---|---|---|---|---|---|
| Under-treatment | Agree with NCCN treatment guidelines | Over-treatment | Under-treatment | Agree with NCCN treatment guidelines | |
| Total | 18 (9%) | 157 (76%) | 32 (15%) | 14 (7%) | 193 (93%) |
| Age (yrs.) | |||||
| <50 | 7 (7%) | 72 (76%) | 16 (17%) | 2 (2%)* | 93 (98%)* |
| ≥50 | 11 (10%) | 85 (76%) | 16 (14%) | 12 (11%)* | 100 (89%)* |
| Gender | |||||
| Female | 5 (6%) | 61 (73%) | 18 (21%) | 4 (5%) | 80 (95%) |
| Male | 13 (11%) | 96 (78%) | 14 (11%) | 10 (8%) | 113 (92%) |
| Training and experience Affiliation with academic medical center | |||||
| No | 13 (9%) | 112 (76%) | 23 (16%) | 12 (8%) | 136 (92%) |
| Yes | 5 (8%) | 45 (76%) | 9 (15%) | 2 (3%) | 57 (97%) |
| Training | |||||
| Board certified or fellowship trained in dermatopathology ** | 4 (5%)* | 73 (90%)* | 4 (5%)* | 3 (4%) | 78 (96%) |
| Other board certification or fellowship training *** | 14 (11%)* | 84 (67%)* | 28 (22%)* | 11 (9%) | 115 (91%) |
| Number years interpreting melanocytic skin lesions | |||||
| <10 | 7 (9%) | 58 (73%) | 15 (19%) | 1 (1%)* | 79 (99%)* |
| 10–19 | 3 (5%) | 52 (83%) | 8 (13%) | 5 (8%)* | 58 (92%)* |
| ≥20 | 8 (13%) | 47 (73%) | 9 (14%) | 8 (13%)* | 56 (88%)* |
| Percent of caseload interpreting melanocytic skin lesions | |||||
| <10% | 9 (10%) | 64 (71%) | 17 (19%) | 9 (10%) | 81 (90%) |
| ≥10% | 9 (8%) | 93 (79%) | 15 (13%) | 5 (4%) | 112 (96%) |
| Average number of benign melanocytic skin lesions interpreted per month | |||||
| <50 | 12 (12%)* | 64 (65%)* | 23 (23%)* | 8 (8%) | 91 (92%) |
| ≥50 | 6 (6%)* | 93 (86%)* | 9 (8%)* | 6 (6%) | 102 (94%) |
| Number of second opinions requested by physician per month | |||||
| <5 | 9 (8%) | 93 (79%) | 15 (13%) | 7 (6%) | 110 (94%) |
| ≥5 | 9 (10%) | 64 (71%) | 17 (19%) | 7 (8%) | 83 (92%) |
| In general, how confident are you in assessments of melanocytic skin lesions? | |||||
| Confident | 17 (10%) | 135 (76%) | 26 (15%) | 12 (7%) | 166 (93%) |
| Not confident | 1 (3%) | 22 (76%) | 6 (21%) | 2 (7%) | 27 (93%) |
*
P-values for Kruskal-Wallis, Chi-square of Fishers exact where appropriate were ≤ 0.05.
**
This category consists of physicians with single or multiple fellowships that include dermatopathology. Also includes physicians with single or multiple board certifications that include dermatopathology.
***
Other includes fellowships or board certifications in surgical pathology, cytopathology, hematopathology, etc.
****
American Joint Committee on Cancer / National Comprehensive Cancer Network.